Successful treatment of vasospastic angina refractory to various therapies using stenting: A case report.

Unlabelled: We encountered a case of coronary angina refractory to multiple medications, including a calcium channel blocker, nitroglycerin, fasudil (a Rho kinase inhibitor), left stellate ganglion block, thoracic sympathetic ganglion blockade, steroids, and denopamine. During the course of treatment, ventricular tachycardia (VT) occurred due to ST-segment elevation, and an implantable cardioverter-defibrillator was implanted; however, the patient had recurrent VT. A 12‑lead electrocardiogram showed ST elevation localized to leads II, III, and a Vf, and stenting was performed in all main trunks of the right coronary artery.

Impact of irrigation flow rates on lesion size and safety of ablation catheters: an ex vivo porcine heart study.

Radiofrequency (RF) catheter ablation is a well-established therapeutic approach for treating arrhythmias, where lesion size and safety are critical for efficacy. This study explored the impact of varying irrigation flow rates on lesion characteristics using the TactiFlex™ SE Ablation Catheter (TF) in an ex vivo porcine heart model, focusing on the size and safety outcomes associated with low versus standard flow rates. Myocardial slabs from porcine hearts were subjected to ablation using two types of irrigated catheters.

Voltage-Guided and Non-Voltage-Guided Superior Vena Cava Isolation in Patients With Atrial Fibrillation.

Background: In addition to the pulmonary vein, the superior vena cava (SVC) is an important focus of atrial fibrillation (AF). However, SVC isolation may cause serious complications, and appropriate settings and techniques for SVC isolation are lacking.

Methods: This study enrolled 86 consecutive patients with AF who underwent SVC isolation.

Rituximab and pericardiectomy with waffle procedure in constrictive pericarditis due to IgG4-related disease: A case report.

We should consider IgG4-related disease (IGRD) as one of the potential causes of constrictive pericarditis. In patients with constrictive pericarditis due to IGRD, the combination of surgical treatment and immunosuppressive therapy may be an effective strategy.

Successful Retrieval of a Torn KUSABI Trapping Balloon Catheter From the Coronary Artery and Verification of the Reproducibility of Trapping Balloon Catheter Shaft Tears.

The balloon trapping technique is frequently used during percutaneous coronary intervention, which is a common treatment for ischemic heart disease. A 68-year-old man with induced ischemia, stenotic lesions, and arterial calcifications underwent catheterization of the circumflex artery and debulking of lesions. During the removal of the catheter, the tip of the balloon catheter used in the procedure dislodged and entered the circumflex artery.

Intramural hematoma extending from a dissection within an implanted stent: a case report treated with fenestration using a cutting balloon.

Background: Dissection after balloon dilation or stent implantation is a common complication of percutaneous coronary intervention. In general, coronary stent implantation for coronary artery dissection is safe when the dissection is completely covered by the stent, particularly when dissection occurs during pre-dilation. However, here, we report a case of severe restenosis caused by a pre-dilation hematoma that extended after stent implantation.

Zinc supplementation in patients with acute myocardial infarction.

This single-centre prospective feasibility study (UMIN000030232) evaluated whether zinc supplementation was safe and effective for improving outcomes among patients with acute myocardial infarction (AMI). Within 24 h after successful primary percutaneous coronary intervention, consenting patients with AMI were randomly assigned 1:1 to receive conventional treatment (conventional treatment group) or conventional treatment plus zinc acetate supplementation (zinc supplementation group). The two groups were compared in terms of major adverse cardiovascular events (MACE), and scar size, which was evaluated using cardiac magnetic resonance imaging (CMR) at 4 weeks after discharge.

Relationship between early drop in systolic blood pressure, worsening renal function, and in-hospital mortality in patients with heart failure: a retrospective, observational study.

This study aimed to determine the optimal cut-off value of the early drop in systolic blood pressure (SBP) for worsening renal function (WRF) in hospitalized patients with heart failure (HF) and analyze predictors of WRF and the early drop in SBP at that threshold. We retrospectively enrolled 396 patients with acute decompensated HF. The early drop in SBP was defined as the difference between baseline and SBP measured 24 h after hospitalization.

Grid-mapping catheters versus PentaRay catheters for left atrial mapping on ensite precision mapping system.

Introduction: Areas displaying reduced bipolar voltage are defined as low-voltage areas (LVAs). Moreover, left atrial (LA) LVAs after pulmonary vein isolation (PVI) have been reported as a predictor of recurrent atrial fibrillation (AF). In this study, we compared grid mapping catheter (GMC) with PentaRay catheter (PC) for LA voltage mapping on Ensite Precision mapping system.

Percutaneous coronary intervention in a patient with heparin resistance due to essential thrombocythaemia: a case report.

Background: Coronary artery disease is uncommon in patients with essential thrombocythaemia (ET); therefore, no treatment strategies have been established.

Case Summary: A 68-year-old man visited our hospital with worsening effort angina complicated with ET. Coronary angiography (CAG) revealed moderate stenosis of the left main trunk and left anterior descending artery (LAD).

Poor prognosis of heart failure patients with in-hospital worsening renal function and elevated BNP at discharge.

Aims: Our purpose was to investigate the association between the B-type natriuretic peptide (BNP) level at discharge, the occurrence of worsening renal function (WRF), and long-term outcomes in patients with heart failure (HF).

Methods And Results: We enrolled hospitalized acute HF patients. We divided patients into four groups on the basis of BNP <250 pg/mL (BNP-) or BNP ≥250 pg/mL (BNP+) at discharge and the occurrence of WRF during admission: BNP-/WRF-, BNP-/WRF+, BNP+/WRF-, and BNP+/WRF+.

The impact of worsening renal function with elevated B-type natriuretic peptide at discharge on 1-year prognosis in heart failure patients.

There are a few studies about the clinical impacts of plasma B-type natriuretic peptide (BNP) at discharge with the occurrence of worsening renal function (WRF) on mortality in patients with heart failure (HF). We divided total 301 patients with acute decompensated HF into four groups by the median value (278.7 pg/mL) of BNP level at discharge and by the occurrence of WRF.

Safety and Efficacy of Tolvaptan for the Prevention of Contrast-Induced Acute Kidney Injury in Patients with Heart Failure and Chronic Kidney Disease.

Background: Tolvaptan is a promising drug for the prevention of contrast-induced acute kidney injury (CI-AKI) because it induces aquaresis without adversely affecting renal hemodynamics. CI-AKI is a major cause of acute renal failure associated with increased morbidity and mortality.

Objective: To investigate the effectiveness of different doses of tolvaptan for the prevention of CI-AKI.

Effect of cutting balloon after rotational atherectomy in severely calcified coronary artery lesions as assessed by optical coherence tomography.

Objectives: Using optical coherence tomography (OCT), we evaluated the effect of a cutting balloon (CB) compared with a conventional balloon after rotational atherectomy (RA) and before stenting in severely calcified coronary lesions.

Background: A CB is designed to create discrete incisions to facilitate fracture of severely calcified plaque.

Methods: OCT was performed preintervention (if possible), post-RA, and poststent implantation.

Impact of recanalization of chronic total occlusion on left ventricular electrical remodeling.

Background: Successful percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) is associated with reduction of cardiac mortality, as well as reducing fatal ventricular arrhythmias. The aim of this study was to evaluate the effect of recanalization of CTO on endocardial left ventricular voltages by paired electrophysiological studies.

Methods: Sixteen consecutive patients who underwent PCI for de novo CTO lesions were included.

Association of Epicardial Adipose Tissue Volume and Total Coronary Plaque Burden in Patients with Coronary Artery Disease.

The relationship between epicardial adipose tissue volume (EATV) and plaque vulnerability in non-culprit coronary lesions is not clearly understood.Fifty-four consecutive patients/158 lesions with suspected coronary artery disease underwent computed tomography (CT) and 40 MHz intravascular ultrasound imaging (iMap-IVUS) in cardiac catheterization. Cross-sectional CT slices were semiautomatically traced from base to apex of the heart.

Serum zinc concentration in patients with acute myocardial infarction in percutaneous coronary intervention era.

Introduction: There were few studies that investigated the association between serum zinc concentration and acute myocardial infarction (AMI) in percutaneous coronary intervention era.

Objective: We assessed the relationships between serum zinc concentration, complications, and prognosis in AMI patients after primary percutaneous coronary intervention.

Methods: We conducted a single-center, prospective, observational study including 50 patients with AMI.

Serial 3-Vessel Optical Coherence Tomography and Intravascular Ultrasound Analysis of Changing Morphologies Associated With Lesion Progression in Patients With Stable Angina Pectoris.

Background: Optical coherence tomographic (OCT) morphologies associated with lesion progression are not well studied. The aim of this study was to determine the morphological change for untreated lesion progression using both OCT and intravascular ultrasound (IVUS).

Methods And Results: We used baseline and 8-month follow-up 3-vessel OCT and IVUS to assess 127 nonculprit lesions (IVUS plaque burden ≥40%) in 45 patients with stable angina after target lesion treatment.

An in vitro experimental model for analysis of central control of sympathetic nerve activity.

Newborn rat brainstem-spinal cord preparations are useful for in vitro analysis of various brainstem functions including respiratory activity. When studying the central control of sympathetic nerve activity (SNA), it is important to record peripheral outputs of the SNA. We developed an in vitro preparation in which neuronal connections between the cardiovascular center in the medulla and SNA peripheral outputs are preserved.